Analysis of the status of excess heart age and its risk factors among residents aged 35 to 64 years in China / 中华预防医学杂志

Objective: To analyze the status of excess heart age and its risk factors among Chinese residents aged 35 to 64 years. Methods: The study subjects were Chinese residents aged 35 to 64 years who completed the heart age assessment by WeChat official account "Heart Strengthening Action" through the internet from January 2018 to April 2021. Information such as age, gender, body mass index (BMI), blood pressure, total cholesterol (TC), smoking history, and diabetes history was collected. The heart age and excess heart age were calculated according to the characteristics of individual cardiovascular risk factors and the heart aging was defined as excess heart age≥5 years and 10 years respectively. The heart age and standardization rate were calculated respectively based on the population standardization of the 7th census in 2021.CA trend test was used to analyze the changing trend of excess heart age rate and population attributable risk (PAR) was used to calculate the contribution of risk factors. Results: The mean age of 429 047 subjects was (49.25±8.66) years. The male accounted for 51.17% (219 558/429 047) and the excess heart age was 7.00 (0.00, 11.00) years. The excess heart age rate defined by excess heart age≥5 years and ≥10 years was 57.02% (the standardized rate was 56.83%) and 38.02% (the standardized rate was 37.88%) respectively. With the increase of the age and number of risk factors, the excess heart age rate of the two definitions showed an upward trend according to the result of the trend test analysis (P<0.001). The top two risk factors of the PAR for excess heart age were overweight or obese and smoking. Among them, the male was smoking and overweight or obese, while the female was overweight or obese and having hypercholesterolemia. Conclusion: The excess heart age rate is high in Chinese residents aged 35 to 64 years and the contribution of overweight or obese, smoking and having hypercholesterolemia ranks high.

Analysis of the status of excess heart age and its risk factors among residents aged 35 to 64 years in China / 中华预防医学杂志

Objective: To analyze the status of excess heart age and its risk factors among Chinese residents aged 35 to 64 years. Methods: The study subjects were Chinese residents aged 35 to 64 years who completed the heart age assessment by WeChat official account"Heart Strengthening Action"through the internet from January 2018 to April 2021. Information such as age, gender, body mass index (BMI), blood pressure, total cholesterol (TC), smoking history, and diabetes history was collected. The heart age and excess heart age were calculated according to the characteristics of individual cardiovascular risk factors and the heart aging was defined as excess heart age≥5 years and 10 years respectively. The heart age and standardization rate were calculated respectively based on the population standardization of the 7th census in 2021.CA trend test was used to analyze the changing trend of excess heart age rate and population attributable risk (PAR) was used to calculate the contribution of risk factors. Results: The mean age of 429 047 subjects was 49.25±8.66 years. The male accounted for 51.17% (219 558/429 047) and the excess heart age was 7.00 (0.00, 11.00) years. The excess heart age rate defined by excess heart age≥5 years and≥10 years was 57.02% (the standardized rate was 56.83%) and 38.02% (the standardized rate was 37.88%) respectively. With the increase of the age and number of risk factors, the excess heart age rate of the two definitions showed an upward trend according to the result of the trend test analysis (P<0.001). The top two risk factors of the PAR for excess heart age were overweight or obese and smoking. Among them, the male was smoking and overweight or obese, while the female was overweight or obese and having hypercholesterolemia. Conclusion: The excess heart age rate is high in Chinese residents aged 35 to 64 years and the contribution of overweight or obese, smoking and having hypercholesterolemia ranks high.

The current situation of blood pressure control and the influencing factors on hypertensive patients in residential communities of China / 中华流行病学杂志

Objective To understand the situation of blood pressure control and the major factors influencing the programs among those hypertensive patients living in the communities from different parts of China.Methods A protocol of community-based standardized blood pressure management was developed based on the current Chinese guideline for prevention,treatment of hypertension.Grass-roots caretakers from community health service centers across China were trained under the requirement of this protocol to manage the hypertensive patients.In this study,the hypertensive patients who had been registered in the project centers from Beijing,Hebei,Gansu,Jiangsu,Zhejiang,Guangdong provinces,were selected as the study subjects,and the baseline data for these patients was analyzed.Results By the end of 2010,a total of 242 182 patients were registered.The mean age was 61.0 ± 10.5,with 48.5％ of them being males.The overall control rate of blood pressure was 27.4％.The control rate was significant lower among patients who were in lower age group,being male,with higher BMI,smoking,drinking or with more salt consumption.However,the control rate was significant higher among those patients who had family history of hypertension,always undertook physical exercise or receiving medical treatment.Conclusion The blood pressure control rate for community hypertensive patients in China was still in a relatively low level.Standardization management measures should be strengthened so as to improve the rate of control on high blood pressure.

Outline of the report on cardiovascular disease in China, 2010 / 生物医学与环境科学（英文）

Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens.

Relations between smoking,alcohol intake,physical activity,sleeping hours and the metabolic syndrome in Chinese male aged 18-45 years old / 中华流行病学杂志

Objective To analyze the relationship between prevalence of metabolic syndrome (MS) and behavior habits such as smoking,alcohol intake,physical activity,sleeping hours.Methods A multi-stage stratified cluster sampling was conducted in 31 provinces,autonomous regions,and municipalities in China according to the program of National Nutrition and Health Survey.Questionnaire survey,interview,physical examination,measurement of biochemical indices,and dietary investigation were done.In total,4937 men aged 18 to 45 years old were selected.Results The MS prevalence was 6.9%(329/4937).The rate of drinking was 49.4% and smoking rate was 54.4%.The percentage of sleeping was hours from 7 to 8 was 70.5%.The percentage of spending time on physical activity over 420 minutes/week was as high as 41.9%.Data from single logistic regression showed volume of smoking more than 600 packs and alcohol intake were associated with high risk of MS and no significantly associations were found between MS and the duration of physical activity and the sleeping time.Multivariate logistic regression showed that the risk of MS in smokers with the volume more than 600 packs age increased significantly as compared to nonsmokers with the odds ratio as 1.443 (95%CI:1.044-1.993 ) and 1.765 (95%CI:1.150-2.708) in smokers with volume from 600 to 899 packs age,and more than 900 packs age respectively.Compared to the nondrinkers,the odds ratios were 1.525 (95%CI:1.135-2.048),2.322(95%CI:1.671-3.255) and 2.033 (95%CI:1.478-2.796) in subjects volume of alcohol dranking as 1 to 2 times per week,3 to 4 times per week and more than 5 times per week respectively.Conclusion Tobacco and alcohol were associated with high risks of MS.

Relationship between duration of low to moderate intensity physical activity and the prevalence of metabolic syndrome / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the relationship between low to moderate physical activity and the prevalence of metabolic syndrome (MS).</p><p><b>METHODS</b>A multi-stage stratified cluster sampling was conducted in 31 provinces, autonomous regions, and municipalities in the interior of China according to the program of the National Nutrition and Health Survey in 2002. Questionnaire survey, interview, physical examination, measurement of biochemical indices and dietary investigation were done. In total, the physical activity of 26 477 persons aged 18 or above were investigated. The duration of low to moderate physical activity was divided into five grades: 0-min/week, 90-min/week, 151-min/week, 301-min/week, over 420 min/week, and the MS prevalence were investigated respectively. The relationship between MS and age (including four age groups 18-, 35-, 45-, 60 or above) or the duration of physical time were investigated.</p><p><b>RESULTS</b>The MS prevalence among persons aged 18 or above was 9.4% (2490/26 477). And the prevalence was 10.3% (1191/11 516) in man and 8.7%(1299/14 961) in women, respectively (χ(2) = 21.035, P = 0.000). The MS prevalence was 2.1% (127/6070) in 18-years old group and 15.0% (1012/6734) in over 60 years old group. The MS prevalence increased with increasing age (χ(2) = 776.768, P = 0.000). 81.2% (21 499/26 477) of subjects engaged in low to moderate intensity physical activity. The percentage of spending time on physical activity over 420 min/week was dominant and as high as 43.7% (11 561/26 477). The MS prevalence was 13.8% (166/1203) for 0-min grade, 13.2% (64/485) for 90-min grade, 11.8% (153/1298) for 151-min grade, 10.1% (124/1225) for 301-min grade and 12.5% (512/4090) for over 420 min grade (χ(2) = 9.58, P = 0.047). Logistic regression analysis results showed, the MS risk of subjects spending 301-min per week on low to moderate intensity physical activity was significantly low than the MS prevalence among subjects of 90-min grade, OR = 0.844 (95%CI: 0.675 - 0.968), and no statistical difference was found in people spending over 420 min per week OR = 0.936(95%CI: 0.769 - 1.136).</p><p><b>CONCLUSION</b>Most of people aged 18 or above engaged in low to moderate intensity physical activity. MS prevalence may be decreased by low to moderate intensity physical activity for 301-min per week, but the decrease was not significant while the duration of time was longer than 420 min per week.</p>

Hypertension Control in Communities (HCC): evaluation result of blood pressure management among hypertensive / 中华流行病学杂志

Objective To determine the effects related to community-based standardized blood pressure management programs on the control of hypertension. Methods A protocol of community-based standardized blood pressure management was developed based on the current Chinese guideline for prevention, treatment of hypertension. Grass-roots caretakers from community health service centers across China were trained using this protocol and required to manage hypertensive patients according to the protocol. Patients were treated on therapeutic life style change or/and medication, and followed up based on the criteria of risk stratification. The control rate of hypertension was evaluated after 1 year. Effect of intervention (EI) was estimated as '1 year rate (mean)' minus the number showed at the baseline. Results By the end of 2008, a total of 29 411 hypertensive patients (47.2% for male, mean age 61.4+10.9 years) with full information had been under management for one year according to the protocol. Among all patients, 8.9% were classified as under low risk, 50.8% as moderate risk and 40.3% as high and very high risk showed in baseline data. After standardized management, the EI of smoking, drinking and systolic/diastolic blood pressure were -7.1% (P<0.05) , -7.3% (P<0.05) , and-14.8/-8.3 mm Hg (P<0.05) , respectively. However, EI of overweight/obesity was 0.3% (P>0.05). For all patients, the control rate rose to 74.7%,with EI as 53.1%, and all of the sub-groups, including age, risk stratification, had significant increases. The longer the management was under, the higher the control rate was seen. Results from the multivariate logistic regression showed that older age, male and having higher blood level were adverse factors for the undertaking the control and management programs of hypertension. Conclusion Results from our study showed that standardized management could significantly improve the program on the control of hypertension at the community level, in China.

The prevalence and onset of age of stroke in Chinese adults / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the prevalence and onset of age of stroke in Chinese adults aged 35 years old and above.</p><p><b>METHODS</b>Data from the 2002 National Nutrition and Health Survey was used to analyze the prevalence of stroke by age, sex, regions, and the differences of onset of age of stroke among the alive patients.</p><p><b>RESULT</b>Standardized prevalence of stroke in Chinese adults aged 35 years old and above was 1111.5 per 100,000, 1258.9 per 100,000 in male which was higher than female (959.3 per 100,000). The prevalence of stroke in urban (1544.8 per 100.000) was higher than that in rural (758.1 per 100,000). The standardized prevalence of stroke in the north (1479.3 per 100,000) was significantly higher than that in the south (719.6 per 100,000). The standardized prevalence of stroke in eastern, central and western region was 1469.0 per 100,000, 1085.4 per 100,000, 614.9 per 100,000, respectively. It is estimated that there were 5.627 million patients with stroke aged 35 years old and above in China in 2002. The age at onset of stroke in the alive patients was skewed distribution. Median was 60 years old. The first incidence of stroke within 60-age group accounted for 32.4%. The age at onset of stroke was no significantly different between male (60 years old, chi(2) = 0.00, P > 0.05) and female (60 years old). The median of the age at onset of stroke (61 years old) in urban was higher than that in rural (58 years old, chi(2) = 17.34, P < 0.01). The median in eastern region was higher than that in central and western regions (57 years old, chi(2) = 12.92, P < 0.01).</p><p><b>CONCLUSION</b>The prevalence of stroke was significant different by sex and regions. Among the alive patients, more than half of their first incidence of stroke were before the age of sixties.</p>

Effect of nutritional status during infancy and childhood on the risk of overweight and obesity in adulthood / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association between fetal nutritional status and overweight and obesity in their adulthood and to provide evidence for formulation of the strategy on preventing low birth weight.</p><p><b>METHODS</b>Using data from 2002 Nationwide Nutrition and Health Survey to set up a case-control method in order to compare body mass index(BMI), prevalence of overweight and obesity as well as to calculate odds ratio of overweight and obesity of case group compared with control group. Three case groups were selected from those who were born in 1959, 1960,1961 respectively, and the controls were those who were born in 1964.</p><p><b>RESULTS</b>The health consequence of being famines on adulthood was evident in women. Means of BMI in women were significantly higher in three case groups than that in control group(P<0.01). After adjustment on geographic regions, the prevalence of overweight in women was significantly higher in three case groups than that in control group(P< 0.01). The prevalence rates of obesity were significantly higher in 1959, 1960 groups than 1964 group(P< 0.05). The odds ratios of overweight of women in three case groups were 28.9% (95% CI:1.063-1.565), 37.2% (95% CI:1. 136-1.658) and 35.2% (95% CI: 1. 103-1.657) respectively, all higher than that in the control group. The odds ratios of obesity of women born in 1959, 1960 groups were 46.5% (95% CI: 1.088-1.972) and 39.6% (95% CI: 1.039- 1.876) respectively, higher than that in the 1964 group. However, such differences were not found in men.</p><p><b>CONCLUSION</b>Higher risks of overweight and obesity in women were caused by malnutrition during their fetal lives. A strategy on preventing low birth weight should be formulated by the government to prevent the chronic disease in adulthood.</p>

The role of dietary factors in chronic disease control in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association of dietary patterns with chronic diseases and their indicators.</p><p><b>METHODS</b>Using the data from 2002 National Nutrition and Health Survey, we divided the subjects into clusters according to their dietary patterns classified by different percentage of energy intake from cereal foods, carbohydrate and fat, respectively. The analysis of variance was used to identify the difference in chronic disease prevalence across clusters of subjects while controlling for age, gender and geographic regions. Logistic regression analysis was applied to calculate the odd ratios (OR) for association of chronic disease and each dietary pattern, after adjusted for age, gender, region, energy intake, leisure time.</p><p><b>RESULTS</b>The higher percentage of energy intake from cereals was significantly associated with lower body mass index (BMI), lower total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C). While it was significantly associated with lower risk for overweight/obesity, hypertension, high total cholesterol, high triglyceride (TG) and high LDL-C, but the prevalence of underweight was significantly higher in the cluster of subjects with cereal energy share more than 75%. The higher percentage of energy intake from fat was significantly associated with higher BMI, higher total cholesterol and higher LDL-C, which accordingly, was significantly associated with higher risk for overweight/obesity, hypertension, high total cholesterol, triglyceride and high LDL-C.</p><p><b>CONCLUSION</b>Our study confirmed the important role of dietary pattern in chronic disease control; in particular, appropriate percentage of energy intake from fat and cereals/carbohydrates are beneficial to control and prevention of chronic diseases.</p>

Economic burden of coronary heart disease and stroke attributable to hypertension in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>1) To estimate annual direct medical costs of coronary heart disease (CHD) and stroke attributable to hypertension among Chinese adults aged 35-74 years in China, 2) to analyze the correlation between the hypertension awareness and hypertension treatment rate.</p><p><b>METHODS</b>2003 National Health Services Survey (n = 93 018) was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nurses fees, and medications. The medical costs of CHD and stroke attributable to hypertension were estimated by multiplying population attributable risk proportion by corresponding disease costs. Using 2002 National Nutrition and Health Survey (n = 148 804), the prevalence of hypertension awareness and hypertension treatment rate in 132 survey sites were calculated. Correlation was used to analyze the correlation between the two variables.</p><p><b>RESULTS</b>The direct medical costs of hypertension, CHD and stroke were 20.2, 15.7 and 24.3 billion Yuan, respectively. The medical costs attributable to hypertension were estimated at 19.1 billion Yuan (RMB), accounting for 47.7% of the total medical costs of the two chronic diseases. The prevalence of hypertension awareness is highly correlated with hypertension treatment rate (r = 0.9777, P < 0.0001).</p><p><b>CONCLUSION</b>The economic burden of CHD and stroke attributable to hypertension is very high, reaching about 50% of the total medical costs of the two diseases. The prevalence of hypertension awareness could be used as an important indicator to evaluate the effectiveness of hypertension prevention and control at community level.</p>

The influence of maternal nutrition on children physical development / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the effect of maternal nutrition status on child growth in China.</p><p><b>METHODS</b>The study was performed using data from 2002 China Nutrition Health Survey in which data were collected through stratified multi-stage cluster samples in 31 provinces, autonomous regions, and municipalities. Accroding to the height of women aged 18-44 y was 156.4 cm, the data on mother and children' weight and height/length (n = 1380) were analyzed.</p><p><b>RESULTS</b>The findings suggest child's length (age 2) were significantly correlated with maternal heights (P < 0.0001). The mean length in children born to mothers with a height below 156.4 cm was 2.4 cm less than those in children born to mothers with a height above 156.4 cm. The prevalence of stunting in children at age 2 born to mothers with a height below 156 cm was 2.07 times of that in children born to mothers with a height above 156 cm. Therefore, the risk for stunting in children at 2 is lower in children born to mothers with greater height.</p><p><b>CONCLUSION</b>The maternal nutrition status could have a significant influence on children physical development.</p>

A description on the Chinese national nutrition and health survey in 2002 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the status of nutrition and health related indices in the Chinese population.</p><p><b>METHODS</b>A stratified multi-stage cluster sampling was used from 31 provinces, autonomous regions, and municipalities. The survey was done in 2002, including data gathered from questionnaires, interviews, physical examinations, measurement of biochemical indices, and dietary investigation.</p><p><b>RESULTS</b>Cereals accounted for 48.5% of all the sources of energy in urban and 61.4% in rural populations. Daily mean percentages of calories for total fat were 35.0% in urban and 27.5% in rural areas. The prevalence rates of stunting and underweight were 14.3% and 7.8% respectively in young children under 5-year-old. The prevalence of vitamin A deficiency was 9.3% in Chinese children aged 3-12 years old. The total prevalence of anemia was 15.2% in general population of all ages. The prevalence of anemia in young adults was significantly higher in women than in men. The total prevalence rates of overweight and obesity were 17.6% and 5.6%, respectively. The prevalence rates of hypertension, diabetes, hypercholesteremia, hypertriglyceridemia, or low serum high density lipoprotein cholesterol were 18.8%, 2.6%, 2.9%, 11.9%, 7.4% respectively in Chinese adults aged 18 and over. The rates of awareness, treatment, and under control among hypertensives were 30.2%, 24.7%, and 25.0%, respectively. Significant regional and age differences were revealed in the dietary habit and the prevalence of various diseases. The prevalence of diseases associated with malnutrition were higher in rural than in urban areas. In contrast, the prevalence of conditions associated with overconsumption and inappropriate dietary patterns were higher in urban than in rural populations.</p><p><b>CONCLUSION</b>Chinese people were currently suffering from both problems on nutrition related issues and burdens of diseases which were characterized in nutrient deficiencies and overconsumption, malnutrition and noncommunicable conditions associated with overconsumption and inappropriate diet. The difference of nutrition and health status between rural and urban people was also seen.</p>

The current prevalence status of body overweight and obesity in China: data from the China National Nutrition and Health Survey / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study on the prevalence of body overweight and obesity in China and its distribution in age, sex and economic development status.</p><p><b>METHODS</b>A total of 209,849 in all ages from the 2002 China National Nutrition and Health Survey (NNAHS) database were analyzed. The year 2000 population census data was used for age standardization. 1978 WHO criteria using Z scores was applied to age 0-7 years, criteria recommended by the Working Group on Obesity in China was applied to those aged 7-17 years and criteria in the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults was applied to those aged 18 years and above.</p><p><b>RESULTS</b>The overall prevalence was 17.6% for overweight and 5.6% for obesity. The combined prevalence of overweight and obesity was 23.2%. The prevalence of overweight was 25.0%, 21.6%, 17.4%, 15.1%, 19.2% and 12.8%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. For obesity, the rate was 10.6%, 7.2%, 6.4%, 4.3%, 6.0% and 2.7%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. By age groups, the prevalence of overweight was 3.4% in children age 0-6, 4.5% in adolescents age 7-17, 22.8% in adults age 18 and above; the prevalence of obesity was 2.0% in children age 0-6, 2.7% in adolescents age 7-17, 7.1% in adults age 18 and above. The sex difference in overweight and obesity differed between urban and rural, and among age groups.</p><p><b>CONCLUSION</b>Overweight and obesity should have affected nearly 1 quarter of the country's total population, and became a threatening hazard to resident's health. As the urbanization progress, obesity might doubly increase. Prevention and control of this hazard should be urgently needed.</p>